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9— <br /> ' MAO CChhe apeg 'Drive• Redwood City, CA 94063 • (650) 364-9600 FAX (650) 36� 93 <br /> j JEQUOIA ANALYTICAL ❑ 819 Striker Ave., Suite 8 •Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑ 404 N.Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> ❑ 1455 McDowell Blvd. North, Suite D • Petaluma, CA 94954 • (707) 792-186_5 FAX (707) 792-0342 <br /> Company Name:AMC &s e Project Name: 3,Axx" 'rre s6ti,,n AJ <br /> Mailing Address: Lone, 'Do t S Billing Address (if different): <br /> City: M State:(20, Zip Code:9535 / Mq ow—a - -- <br /> Telephone:2 _ 5.79- Z?--Z.( FAX #:•2eP—5'7q-ZZZ5" P.O. #: <br /> C <br /> a� <br /> [Report To:JeaK&-ke t4v Sampler: 4teX ro,,e QC Data: RIfevel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround KY1-0 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> O a <br /> Time: ❑ 7 Working Days Cl 2 Working Days ❑Waste Water „Ip <br /> ❑ 5 Working Days ❑24 Hours I*Other <br /> Client Date/Time Matrix # of Cont. Sequoia's �v Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # '`r? <br /> 1. N1 - Q. vJ' S iia D ✓ ✓ - I U da 'IAT <br /> 2. MKI-2- e6it� � J 02 ✓ <br /> 3. M w- 3 eb�«9 025 5 o a ✓ ✓ 3 <br /> 0 <br /> 4. } <br /> 5. <br /> 6. <br /> 7. Ea <br /> • 0 <br /> 8. <br /> 9. <br /> L <br /> 10. <br /> 1 T <br /> Relinquished By: A 4,5�, Date:Q(D(j 19 Time: f(o5 Received By: � Date. - �9 Time: <br /> Relinquished By: Date: Time: Received By: Date:(3G11Time: t Q <br /> L <br /> linquished By: DateAm Time: Received By Lab: Date: Time: t <br /> les Received in Good Condition? ❑Yes ❑ No Samples on Ice? dYes 0 No Method of Shipment t)uri.2'v- Page L of V <br />